The Long-Term Effect of Preterm Birth on Renal Function: A Meta-Analysis

Area of Science:

• Nephrology
• Neonatology
• Public Health

Background:

• Improved survival rates for premature births lead to a growing adult population born preterm.
• Long-term health consequences, particularly renal function, in this population require thorough investigation.
• Understanding the renal impact of preterm birth is essential for lifelong health management.

Purpose of the Study:

• To conduct a meta-analysis investigating the long-term effects of preterm birth on renal function in adult survivors.
• To compare renal function parameters between individuals born preterm and those born full-term.

Main Methods:

• Systematic literature search of PubMed and EMBASE databases for relevant studies.
• Inclusion of studies comparing renal function in preterm survivors and full-term controls.
• Meta-analysis using a random effects model with standardized mean difference (SMD) and heterogeneity assessment (I² statistics).

Main Results:

• Preterm survivors exhibited significantly decreased glomerular filtration rate (SMD -0.54) and effective renal plasma flow (SMD -0.39).
• Kidney length (SMD -0.73) and volume (SMD -0.82) were significantly reduced in preterm survivors.
• Increased urine microalbumin to creatinine ratio and elevated systolic/diastolic blood pressures were observed in the preterm group, despite normal serum creatinine and blood urea nitrogen levels.

Conclusions:

• Preterm-born adults are at higher risk for diminished kidney function, including reduced filtration and increased albuminuria.
• Decreased kidney size and volume, along with hypertension, are significant long-term consequences of preterm birth.
• These renal impairments can occur even when standard laboratory markers remain within normal ranges, highlighting the need for specific monitoring.